Monday, July 30, 2007

Health Care

Some companies are offering stick-and-carrot approaches to employees in an effort to reduce health care. While I don't like such approaches, they are the inevitable result of employer-paid health care.

Does anyone know why we in the United States assume that our health care costs will be borne by our employers?

Well kids, our story takes place in World War II. We got pretty close to socialism in that war, what with wage and price controls, rationing, the New Deal (under which we still suffer), etc. Companies, limited by government in what they could pay employees, found ways around the limits by offering non-taxable perks--including health care. Now, more than 60 years later, we live in a society that expects employers to fund health care coverage. What a perversion.

So what are companies doing today in order to cut costs?

Looking for new ways to trim the fat and boost workers' health, some employers are starting to make overweight employees pay if they don't slim down...

In one of the boldest moves yet, an Indiana-based hospital chain last month said it decided on the stick rather than the carrot. Starting in 2009, Clarian Health Partners will charge employees as much as $30 every two weeks unless they meet weight, cholesterol and blood-pressure guidelines that the company deems healthy.

Those of you who adore the nanny state might very well say, "Good! It's what's best for those people." I, on the other hand, don't have a problem with the market approach--those who cost the system more should pay more.

However, what happens when government runs health care and compels people to lose weight? Then it becomes an issue of the coercive power of the state versus individual freedom, and that's an entirely different game.

One California school district is looking at getting into this game:

[T]he Los Angeles Unified School District, which has 90,000 employees, is researching financial incentives and disincentives to help bring down healthcare costs.

There are some interesting issues relating to these reward-and-punishment proposals when instituted by companies; what happens when the government itself starts implementing requirements "for the public good"? Will we have Prohibition II? Will smoking be outlawed? Will we have mass public calisthenics each morning like they (used to?) have in China? Will certain foods be taxed more, or forbidden?

Critics of the lose-it-or-pay trend say that companies that charge overweight employees more for their medical coverage are turning the healthcare system into a police state and, just as worrisome, are working off of a false assumption that it's easy for people who are obese and have other health issues to change their situations...

Lewis Maltby, president of the National Workrights Institute, a Princeton, N.J.-based employee rights group, called the trend "a very dangerous road that could lead to employers controlling everything we do in our private lives."

If you don't want your employer controlling what you do in your private life, the thought of government's being in that position should send a chill down your spine.

And do you foresee many new "disabilities" to create loopholes?

Still, some lawyers say weight-based compensation plans may run afoul of other employment laws.

"A key protection in the Americans with Disabilities Act is that employers can't discriminate against employees based on their health status," said J.D. Piro, a principal at Hewitt Associates' healthcare law group. "This is a fight that's likely going to be dealt with in the courts."

Smoking, drinking, overeating, addiction to high-calorie foods--all will become "disabilities".

In Arkansas, Deeann Gutekunst, 42, a Benton County deputy treasurer, said she understood the rationale for the county's policy.

"If you have employees who don't care about their health," she said, "what else are you supposed to do?"

Of course, the solution is to compel them. Right.

How about this solution? How about we create a "wall of separation" between employer and health care? How about we let the marketplace take care of health care, the same way it takes care of groceries, housing, cars, and most everything else we need in our daily lives?

This isn't an area that requires more government intervention--heck, it was government intervention that got us here in the first place. This is an area that requires less.

But people aren't going to want to give up their "free" (employer-provided) health care. This is exactly why we don't need to go any further down the road to socialism--because any time someone gets something for which they don't have to pay money directly from their own pocket, they think it's free. It's too abstract to realize that every cent your employer pays for your health care--or for your social security, for that matter--is money that can't go into your pocket. Our health care situation in the United States is nowhere near ideal, but I can see no improvements at all by bringing it completely under the jurisdiction of the very government that created the employer health care mess in the first place.

Private health insurance is forbidden in Canada--except in Quebec, where the High Court ruled that too many people are dying while waiting and must be allowed to get private insurance. Another case is pending in Toronto. What will happen in Canada is this: there will be a two-tiered health care system, one for the "haves" and one for the "have-nots". Everyone will have the least common denominator, government-run health care program, which requires exceedingly long waits for what we in the US consider routine exams, and those who can afford it will have better. Given that, what good has Canada's system provided?

Here's the situation in Toronto:

It started when McCreith, a resident of Newmarket, north of Toronto, suffered a seizure last year. He was told in Canada he would have to wait more than four months for an MRI to rule out a malignant tumor.

Rather than wait, McCreith, 66, quickly arranged a trip to Buffalo for a scan. The MRI confirmed his worst fears — a cancerous growth that a Buffalo neurosurgeon removed a few weeks later.

“If I had been patient, I’d probably be disabled or dead today,” McCreith said.

Now, McCreith is suing the Ontario government in a closely watched constitutional challenge that could reshape universal health coverage in the province by striking down the prohibition against patients buying private insurance.

On this side of the border, advocates of universal health insurance champion Canada’s popular public program as a fairer system that the United States should emulate, as seen in Michael Moore film, “Sicko.” Yet critics see the long waits for some services in Canada — mainly for non-emergency surgery — as an argument against an increased role for government in health care.

With Medicare, Medicaid, and (in California) Medi-Cal, even the poorest wouldn't suffer what McCreith suffered in his first-class, G-8 government-provided health care.

For those of you who think socialism will level the playing field, you're right. It brings everyone down to the lowest level. And then the "haves", especially those in government, start making exceptions for themselves. Is that really what you want?

6 comments:

Still the same garbage - looking at how to pay for healthcare without one concern abour controlling costs. Stop paying physicians for overutilization and self referral to their owned laboratories, imaging departments, ambulatory surgical centers, and home nursing services and bring the cost of medical necessity healthcare back to reality.